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Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease.

Publication ,  Journal Article
Neuschwander-Tetri, BA; Clark, JM; Bass, NM; Van Natta, ML; Unalp-Arida, A; Tonascia, J; Zein, CO; Brunt, EM; Kleiner, DE; McCullough, AJ ...
Published in: Hepatology
September 2010

UNLABELLED: The Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) was formed to conduct multicenter studies on the etiology, contributing factors, natural history, and treatment of nonalcoholic steatohepatitis (NASH). The aim of this study was to determine the associations of readily available demographic, clinical, and laboratory variables with the diagnosis of NASH and its key histological features, and determine the ability of these variables to predict the severity of nonalcoholic fatty liver disease (NAFLD). A total of 1266 adults were enrolled in NASH CRN studies between October 2004 and February 2008, of whom 1101 had available liver histology. The median age was 50 years; 82% were white and 12% Hispanic. The median body mass index was 33 kg/m(2); 49% had hypertension and 31% had type 2 diabetes. On liver biopsy, 57% were judged to have definite NASH and 31% bridging fibrosis or cirrhosis. Using data from the 698 patients with liver biopsies within 6 months of clinical data, patients with definite NASH were more likely to be female and have diabetes, higher levels of aspartate and alanine aminotransferases, alkaline phosphatase, gamma glutamyl transpeptidase, and homeostasis model assessment of insulin resistance (HOMA-IR). Progressive models for predicting histological diagnoses performed modestly for predicting steatohepatitis or ballooning (area under receiver operating characteristic curves [AUROC] ranged from 0.70-0.79), and better for advanced fibrosis (AUROC 0.73-0.85). CONCLUSION: Readily available clinical and laboratory variables can predict advanced fibrosis in adults with NAFLD, but additional information is needed to reliably predict the presence and severity of NASH. Prospective studies of this well-characterized population and associated tissue bank samples offer a unique opportunity to better understand the cause and natural history of NAFLD and develop more precise means for noninvasive diagnosis.

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Published In

Hepatology

DOI

EISSN

1527-3350

Publication Date

September 2010

Volume

52

Issue

3

Start / End Page

913 / 924

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Prospective Studies
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Liver Cirrhosis
  • Liver
  • Humans
  • Gastroenterology & Hepatology
 

Citation

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Neuschwander-Tetri, B. A., Clark, J. M., Bass, N. M., Van Natta, M. L., Unalp-Arida, A., Tonascia, J., … NASH Clinical Research Network, . (2010). Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease. Hepatology, 52(3), 913–924. https://doi.org/10.1002/hep.23784
Neuschwander-Tetri, Brent A., Jeanne M. Clark, Nathan M. Bass, Mark L. Van Natta, Aynur Unalp-Arida, James Tonascia, Claudia O. Zein, et al. “Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease.Hepatology 52, no. 3 (September 2010): 913–24. https://doi.org/10.1002/hep.23784.
Neuschwander-Tetri BA, Clark JM, Bass NM, Van Natta ML, Unalp-Arida A, Tonascia J, et al. Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease. Hepatology. 2010 Sep;52(3):913–24.
Neuschwander-Tetri, Brent A., et al. “Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease.Hepatology, vol. 52, no. 3, Sept. 2010, pp. 913–24. Pubmed, doi:10.1002/hep.23784.
Neuschwander-Tetri BA, Clark JM, Bass NM, Van Natta ML, Unalp-Arida A, Tonascia J, Zein CO, Brunt EM, Kleiner DE, McCullough AJ, Sanyal AJ, Diehl AM, Lavine JE, Chalasani N, Kowdley KV, NASH Clinical Research Network. Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease. Hepatology. 2010 Sep;52(3):913–924.
Journal cover image

Published In

Hepatology

DOI

EISSN

1527-3350

Publication Date

September 2010

Volume

52

Issue

3

Start / End Page

913 / 924

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Prospective Studies
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Liver Cirrhosis
  • Liver
  • Humans
  • Gastroenterology & Hepatology